| Vertebral artery complications in anterior approaches to the cervical spine: report of two cases and review of literature. | |
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MedLine Citation:
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PMID: 12748015 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cases of lesions to either the carotid artery or the vertebral artery in anterior approaches to the cervical spine are rarely found in medical literature. Two cases of vertebral artery injury in anterior approaches as well as a review of the pertinent literature are presented. In cases of arterial injury, appropriate management strategies are necessary to avoid or minimize harm to the patient. CASE REPORTS: In the first case, the vertebral artery was injured during decompression of a cervical spinal stenosis while drilling the neuroforamen. Local compression provided sufficient control of hemorrhage. Nevertheless, rebleeding from a pseudoaneurysm occurred 2 days later. After removal of the hematoma, the pseudoaneurysm was treated successfully with coils by an endovascular approach. In the second case, misplacement of one screw in screw-fixation of a type II odontoid fracture caused a pseudoaneurysm of the vertebral artery. This led to a fatal subarachnoid hemorrhage 4 days later. CONCLUSIONS: In ventral approaches to the cervical spine, precise preoperative planning and a detailed knowledge of the surgical anatomy are mandatory. In cases of injury to the vertebral arteries, direct surgical repair is most appropriate to prevent complications arising from fistulas, late-onset hemorrhages, pseudoaneurysms, thrombosis, and emboli. Alternatively, endovascular techniques or even clipping or ligation of the affected artery should be considered. |
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Authors:
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Dorothea Daentzer; Wolfgang Deinsberger; Dieter-Karsten Böker |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Surgical neurology Volume: 59 ISSN: 0090-3019 ISO Abbreviation: Surg Neurol Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-05-15 Completed Date: 2003-05-27 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 0367070 Medline TA: Surg Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 300-9; discussion 309 Citation Subset: IM |
Affiliation:
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Neurosurgical Clinic, Justus-Liebig-University Giessen, Giessen, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aneurysm, False / etiology Bone Screws Cervical Vertebrae / pathology, surgery Decompression, Surgical / adverse effects* Fatal Outcome Female Humans Male Middle Aged Postoperative Complications* Spinal Stenosis / surgery* Subarachnoid Hemorrhage / etiology*, pathology Vertebral Artery / injuries* |
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